This disclosure relates to methods and system to detect hand motions. According to one specific exemplary embodiment, provided is a system and method relating to the diagnosis of Parkinson's disease with a diagnosis metric.
Parkinson's disease (PD) is a progressive and incurable disease and results in considerable utilization of health and community services. Currently, about 1 million Americans or about 1 percent of the population over 60 years of age, are suffering from this disease and this number is expected to rise fourfold by 2040. The cost per patient per year in USA is around 10,000 USD. PD, the second most universal chronic neurodegenerative disease after Alzheimer's disease, is characterized by the loss of dopaminergic neurons in brain. The loss results in dysfunction of circuitries that are responsible for motor and cognitive functions. The key motor symptom is restriction of mobility that reveals as bradykinesia, rigidity, rest tremor, and postural instability. Bradykinesia, i.e., slowness and decrement in movement, is the major symptom of PD and is, therefore, crucial for diagnosis and for estimating the severity of the patient's functional disability.
Reliable clinical evaluations are important, as patients need to be followed up with frequent treatment adjustments for many years. Medicine dosing may need to be adjusted with respect to patient's performance in order to slow down the loss of dopamine.
The motor clinical characteristics of PD are usually quantified by physicians using validated clinical scales such as Unified Parkinson's Disease Rating (UPDRS). The examination requires the Specialists in Movement Disorders (SMDs) to score motor disturbances on a 5-point scale ranging from 0 (normal performance) to 4 (severe, unable to perform the task) on the basis of visual inspection. However, the assessment is subjective and requires considerable experience and monitoring to minimize variability among different raters. Analyzing finger tapping movement is a prevalent evaluation method used in clinics for motor function estimation due to the fact that the rhythm of the movements acts as an efficient index for cerebellar function testing. See G. Holmes, “The symptoms of acute cerebellar injuries due to gunshot injuries”, Brain, vol. 40, No. 4, pp. 461-535, 1917.
The periodic rhythm of the dominant hand finger movements acts as an efficient index for evaluation of brain motor function. To achieve a reliable, quantitative and objective clinical assessment, previously published scientific works use electrocardiographic apparatuses, accelerometers, gyroscopes, lightweight magnetic sensors, camera systems with active/passive markers and 3D images captured from infrared cameras. Some of this equipment can influence the results due to their weight, unnatural form, and the connected wires, which can be invasive and distracting. Also, the equipment is expensive and/or requires supervision.
Another approach to assessment is via telemedicine and remote viewing by a specialist. This remote delivery of healthcare services and clinical information using telecommunications technology is especially valuable to chronically ill patients in remote, rural and underserved areas who may not otherwise receive such care. In case of PD, 42% of the patients don't get the specialized care of a neurologist, which places these individuals at a great risk. Thus, PD particularly lends itself to telemedicine because, as mentioned earlier, many aspects of the diagnosis and treatment process are on the basis of visual inspection. While televiewing provides advances, it does not address the issue of the relative lack of qualified healthcare practitioners to the population for current protocols, and doesn't address the desire for increased numbers of assessments of the desired protocols, i.e., regular monitoring under a variety of conditions and to test new protocols. Further, it also does not eliminate the rater variability issue.
A cost-efficient system and methodology for objective measurement of these variables for a patient performing the task in front of a camera at home or at a clinic is desired.